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General NPI Number Information
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NPI Number | 1518783497
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Entity Type | Organization
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Legal Business Name | L & L ANCHORAGE HOMES II LLC
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Dates
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Enumeration Date | 11/25/2024
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 3843 N 51ST BLVD
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City | MILWAUKEE
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State | WI
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Zip | 53216-2303
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Country | US
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Telephone | 414-550-8098
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Fax | 414-875-8272
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Provider Business Mailing Address
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Address Line | 5340 W MELVINA ST
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City | MILWAUKEE
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State | WI
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Zip | 53216-2218
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Country | US
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Telephone | 414-550-8098
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Fax | 414-875-8272
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Authorized Official
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Title or Position | PRESIDENT
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Name | LUREAN NELSON
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Credential | RN
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Telephone | 414-550-8098
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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